Sex Addiction Therapist: Most likely, you'll end up going the way of David Carradine and Michael Hutchence: Autoerotic Asphyxiation.

Kenny: Autoerotic asphyxiation? What's that?

Therapist: I don't want to go into too much detail but — you choke yourself with a belt around your neck while masturbating dressed up like Batman or something then you pass out from lack of air and apparently it makes your orgasm super awesome.

"Intentionally cutting off oxygen to the brain for sexual arousal", to quote The Other Wiki. A general term for sex acts that involves either restricting one's own breathing for intensified sensations during masturbation or one party restraining the breathing of another. Needless to say, this particular paraphilia includes all the risks associated with asphyxiation, including fatalities. Thus it's generally considered to fail the "safe" part of Safe, Sane and Consensual, particularly when it involves constricting the throat as it is usually portrayed in fiction. Sometimes it will be a plot point that what at first appears to be a masturbation session gone wrong is actually a disguised murder.

For clarification, autoerotic asphyxiation is doing it yourself, as opposed to getting someone else to do it to you. For obvious reasons, this is even more dangerous - to the extent that many of the more famous deaths from it have happened that way. Also, being drunk or under the influence of drugs that affect alertness (whether by making you feel more alert than you are or by lessening awareness and consciousness/depressing the central nervous system) increases the odds of dying, especially if combined with doing it solo.

Finally, even if you don't die, you can put yourself at risk for chronic traumatic brain damage (in the same way people who suffer from repeated mini-strokes or concussions do - cutting off oxygen to the brain for any amount of time damages it, even if the damage is not noticeable immediately, brain damage is cumulative), a major stroke that may be delayed due to damage to the arteries in the neck/dislodging fat or a clot in one of them, and/or weakening or breaking the bones in your cervical spine, causing anything from chronic pain to death when/if the wrong one breaks. The risk of both stroke and broken neck vertebrae is also multiplied exponentially if you do anything else - from playing football or hockey to headbanging or having your hair done in beauty salons a lot - that inflicts trauma to the region.

Examples:

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Anime & Manga

In the Full Metal Panic! novels, Gauron once had a thing with a female scientist and strangled her. They both seemed to get off on it, as Gauron even lampshades it by mocking her, asking her if she actually likes making him angry, and actually wants him to hurt her. He says this with a perfect mixture of "coldness and joy," and she responds by gasping with "pain and ecstasy."

In Starman, the ghost of the Black Pirate describes the sensation of being hanged and says you start to feel sleepy, but everything's awake below the waist. Jack admits that he's actually experienced this with an ex-girlfriend. The ghost then asks if Jack's experienced what happens next, when everything goes to sleep, and Jack obviously hasn't.

Film

Killing Me Softly, a grade B sex-drama, featured Joseph Fiennes tying Heather Graham into a rig that used yards and yards of silk to induce erotic asphyxiation. Of course, this was him getting off on strangling her while they screwed, not her getting off on getting strangled...

The Mechanic (2011). Bishop kills an Arms Dealer this way to Make It Look Like an Accident, strangling him with his own belt, then hanging him up with some porn playing on a laptop in front of him. His protege Steve then makes the mistake of trying to copy this method on his first target — unfortunately his victim is a very fit and powerfully built hit man.

A Pokemon fanfic (one of a series that begins with Sword and Shield and features Mewtwo as the partner to a human homicide detective named Brenda Johnson) has Mewtwo and Brenda investigate one of these gone wrong. Mewtwo is disturbed, while the rather jaded Brenda finds it darkly amusing.

Literature

This accidentally happens to Colonel Sebastian Moran in the first story of The Hound of the D'Urbervilles, he gets tied up and noosed, and unwantedly develops an erection, in front of the man he was trying to kill, his woman, and their adopted daughter. Its played for laughs, and Moran mentions he knew a guy who liked to do it on purpose.

Naked Lunch: William Burroughs has a habit of writing scenes where teenage boys very sensually get their necks broken via noose.

In Hannibal, Mason Verger was into this, but it backfired when Hannibal tricked Verger into cutting his face off and feeding it to his dogs while high out of his mind, and then used the setup to hang him. Verger survived, but horribly maimed and paralyzed.

Terry Miller has a fetish for strangulation, which gets confused for this in Skinjumper. Amusingly, despite being a serial killer, he finds the concept of consensual choking during sex to be weird.

Live Action TV

Six Feet Under had an opener death caused by autoerotic asphyxiation. The dude's wife is devastated and had no idea he was into that stuff.

On The X-Files, Clyde Bruckman (who can see how anyone will die) implies that Mulder will die this way.

Bruckman: You know, there are worse ways to go, but I can't think of a more undignified way than autoerotic asphyxiation.

This sort of happens on True Blood, but with a twist. Jason is screwing some girl and she's tied up and he chokes her a little, and she "dies". He freaks out and leaves, and then she wakes up—she was just pretending. But then the real serial killer walks in and kills her. Of course, Jason is accused of her murder and even believes himself that he killed her.

The Whitest Kids U Know: This was the subject matter of a sketch. The guy dies, and his ghost is forced to watch as people keep walking in on him in increasingly compromising situations.

The first is when the teenage goth Valerie starts to strangle Mark during sex. He's terrified and thinks she's trying to kill him, until afterwards when she explains that her ex-boyfriend used to love it (Mark still finds it a bit disturbing though).

Jeremy gets so dangerously bored sitting around the house doing nothing that he threatens to try "that thing Michael Hutchence did".

At one point much later in the series, we get this quote from Mark:

"If he hangs himself over this, I can stick an orange in his mouth and call it a fatal wanking accident."

Queer as Folk (the US version) has Brian trying this in the first season finale, but he's pulled down by Michael before anything horrible can happen.

The 1970 Hawaii Five-O episode "Bored She Hung Herself" was about a deadly yoga technique that had more than a passing resemblance to Erotic Asphyxiation. Allegedly, a viewer tried to imitate the technique and died, which is why "Bored She Hung Herself" has been a Missing Episode ever since.

One episode of House features a man who is into dominance/submissive sex and he likes to be choked.

Game of Thrones: This is cited in a deleted scene in Season 2 where former Sex Slave Doreah is strangling Irri to death.

"A trader from Qarth told me the greatest pleasure comes from a silk cord around the neck, tied very, very, tight. (victim clutches futilely at the cord) The reason so few people indulge in this...exquisite pleasure...he told me it's the danger. A moment too long, and ecstasy becomes death. (goes limp) It is known."

Oz. After being forced to become the sex slave of his cellmate, Robson talks him into trying this method, then 'forgets' to cut him down, thus killing him and making it look like a suicide at the same time.

On NYPD Blue, one of the civilian assistants is into asphyxiation and sees one of her partners die from lack of oxygen. This is an awkward case for Sipowicz because she had made unsubtle passes at him while working at the precinct.

The deaths of at least two famous musicians in what seemed to be this way is how the concept entered public consciousness both in the Western world (as a result of Michael Hutchence) and in Japan (as a result of a common assumption regarding hide) and made it Memetic Mutation as a "badass" or Sex, Drugs and Rock & Roll way to die.

Theater Hopper had some people wondering why Vader was strapped to a table in the first Revenge of the Sith trailer, and wondered it he liked that stuff, supporting it with him wearing leather, and that he likely choked officers for this trope.

The protagonist of Chopping Block once killed an entire band and made it look like they'd inadvertently strangled themselves during an autoerotic asphyxiation circlejerk. He described this as "priceless."

Cheryl likes to be strangled during sex due to her fetish for murder fantasies. Although she is unusual because she doesn't seem to specifically want to be deprived of oxygen so much as she's aroused by the thought of being murdered.

In "Double Deuce," Woodhouse finds out the "mysterious death" of one of his old war buddies was just an attempt to cover up an autoerotic asphyxiation mishap.

Woodhouse: You know, I do recall a lot of loose doorknobs... Stinky: And there was his plane's name. Woodhouse: I always thought that had something to do with his engine. (raises glass) Here's to you, "Choke 'n' Stroke."

In American Dad!, there is an episode where Stan attempts to kill himself by hanging being one-upped by Steve and Roger. Steve freaks out and Roger is seriously unimpressed, even commenting, "Stan, are you killing yourself or thrilling yourself?"

Klaus mentions having nearly died in this act while comparing it to the satisfaction of killing Steve's MMO character.

In "Minstrel Krampus", Roger gets a Too Kinky to Torture moment when Santa's elves try to strangle him

In Metalocalypse, when Pickles has to go to rehab the other bandmates suggest autoerotic asphyxiation as a possible substitute. Ofdensen thinks that's a horrible idea, but the other bandmates think it's a badass way to die.

In an episode of The Cleveland Show, Donna reveals she was faking being injured and strangles Holt threatening to kill him if he tells Cleveland. Then she notices him undoing his pants.

A Cutaway Gag has Cleveland at David Carradine's funeral, giggling inappropriately at a eulogy with a lot of Accidental Innuendo. He apologizes, to which the minister says it's ok because autoerotic asphyxiation is a funny way to die. Cleveland replies, "You can die from that?" and starts crying.

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